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Home My WebLink About06-23-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 014621 DAVIS DOROTHY M 1652 DOE RUN ROAD MIFFLINTOWN, PA 17059 fold ESTATE INFORMATION: ssrv: 163-48-3342 FILE NUMBER: 211 1-0587 DECEDENT NAME: TUCKER LINDA M DATE OF PAYMENT: 06/23/201 1 POSTMARK DATE: 06/22/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 05/01 /201 1 REMARKS: CHECK# 3519 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 1 1 136385 ~ $106.87 TOTAL AMOUNT PAID: INITIALS: CJ REV-1162 EX(11-96) S 106.87 GLENDA EARNER STRASBAUGH RECEIVED BY: REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU DF INDIVIDUAL TAXES AN D Po Box z8B6o1 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (88 -08) FILE NO.~a~~~~"'S$~ ACN 11136385 DATE 05-27-2011 FILED EST. OF LINDA M TUCKER OF ORPHANS' URT SSN 163-48-3342 DATE OF DEATH 05-01-2011 1t 20,11 COUNTY JUNIATA J U REMIT PAYMENT AND FORMS TO• TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. DOROTHY M DA IS REGISTER OF WILLS ~~ c. .. rn 1652 DOE UN R P 0 BOX 68 ~ ~ ~ r.~. MIFFLINTO EAP10Fi1~l~,JUN CO. MIFFLINTOWN PA 17059 ~~ ~ ,~, "[~ I~IFFLINTOWN, PA ~~ ,~ rv ', ~~ ~ ~ ~Q~ ~ Y- ~ '"r> FIRST NB OF MIFFLINTOWN provided the Department with the information below, which has been used ~ calcula~g thy- '~ potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/bena~ciary of th,~ accolirnl.d If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to "this form ~ and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowmonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 4103049 Date 05-3 1-2007 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 5 , 000 .00 payable to "Register of Wills, Agent". Percent Taxable X 50 .000 NOTE: If tax payments are made within three Amount Subject to Tax $ 2 ,500 .00 months of the decedent's date of death, Tax Rate X . 045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become del inquent Potential Tax Due $ 112 .50 nine months after the date of death. PART TAXPAYER RESPO NSE 1^ ~, \~ ~ FAI~t~~~ Om,RESP D LL (~ ~ L T IN OFF~~IAL~TAX ASSESSMENT A. ~/) The above information and tax due is correct. t/~, Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3^ below. PART If indicating a different tax rate, please state ~~~~ OFFICIAL US ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINt 1 . irate Established 1 ~ 1 2. Account Balance 2 $ ~ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 S 6. Amount Taxable 6 $ ~ 6 7. Tax Rate 7 X ~ 7 8. Tax Due 8 $ ~~~ $ TOTAL CEnter on Line 5 of Tax Computation) 8 Under penalties of perjury, I declare that the facts I have reported above are t ire, correct avid complete to the best of my knowledge and belief. HOME C~~~1 ) ~~~ '~" Z-~V ~ WORK C ) (~-Z-E~_~ ..~ tYV1 ~ TAXPAYER SI~,G T R TELEPHONE NUMBER DATE PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~ 4 .. USA Fl~ T~L, 5 R~ER: :i, 4 ~ } ' {f ~~ ~ I' ~ F. ~~ ; ~ ry# + ~ ~ ~ O k ~ '~ t 4 . k ~y ~ ~}. (~ Q ~ ^ S"" d ~ ~ ~ o I ~ :. t~ ~ j c- r -~ ~ ~-- ~~~~ f~~ O 4;L. t~ ~ , ~~ ~~ v r'~ F~, ~~ ,A: ;~ _ s ~ ~ ~~ ~ ~ j ~ ~ ~ ~ ~ ~. ~ ~ ~ f `-~ ~ ~ ~' r~ ~ u~ :~;,r ~t: X33 + ~~r ~~ ~~,~ ~1~Z ~ 1, :C~'i , ~ j i ~'• 'Z ^~ ... ~F~i,~ t.:Y i ~~ ~:ali.! {~~ Q~ 3t .~